How to study for Step 1 Usmle

How to Study for Step 1 Usmle

Step 1 is probably going to be one of the most difficult exams you will write in your medical career. Scoring well on this exam is necessary for matching into your residency of choice. So, the question is, what is the best approach to ace your exam? We’ve looked at advice and comments from past test takers to come up with the best test resources, schedules, and study approaches.

First Aid for the USMLE Step 1

To ensure that you cover all the most important topics, you will need a a general review book. First Aid for the USMLE Step 1 is the best book for this. It lacks detailed explanations, but has all the key topics and facts you will need to know. What most students do, is annotate First Aid with details from other sources. For example, taking any extra details or facts from a question bank such as USMLE World. To annotate effectively, it is best to have a few coloured pens, highlighters and fill in the margins. It may also be helpful to unbind First Aid and put the pages in a binder, then to add blank pages. This method allows for more annotations, charts, and even images to be added. If you have an iPad or another writing tablet, you can annotate First Aid using an app like Goodnotes, Notability, or Microsoft One Note.

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Pathology is one of the most difficult subjects to study for the step 1 exam. Pathoma has been the go to resource for medical students for the last few years. The book can be bought on amazon. However, the combination of the videos and book, available on Dr. Sattar’s website, is the best option for most. The videos are loved because of the easy way that Dr. Sattar explains concepts. The videos consist of slides that closely follow the book and he adds little drawings and explanations. 

The book has wide margins, perfect for annotating from his videos and from other sources. Many students choose to unbind the book, allowing for pages to be added and for more annotations to be made.

USMLE World Question Bank

This is the question bank that most students consider essential to passing the step 1 exam. The questions are quite difficult, often more difficult than those on the actual exam. The format is similar to the step 1 exam. And it is very predictive of your actual exam score. What we found to be the best feature, was the detailed explanations. Doing practice questions familiarizes you with questions you are likely to see on your exam. 

There is a tutor mode, which is great for learning. During your first and second years you can go through questions by subject and in tutor mode to cover topics you have not yet mastered. Once your exam is near, you can go over topics you’ve mastered in timed and random mode. 

Uworld also offers self assessment exams. We recommend you do one of these before starting your dedicated step study to assess what subjects you already know and what subjects you need to focus on. Then to do your weakest subjects first, followed by your strongest, then to do the entire question bank a second time in timed-random mode.

Kaplan Question Bank

The Kaplan USMLE preparation resources are very popular among international medical graduates. The question bank costs less than UWorld and the questions are pretty good. The explanations are detailed and complemented by other resources available from Kaplan — such as their books, videos, and live courses. 

Many students choose to use this as an additional question bank — they use Uworld as their main question bank and then use Kaplan after finishing Uworld. Doing more questions only helps. However, we suggest using the Kaplan question bank in your pre-step 1 study period. By doing this question bank as you study in first and second year, you can expose yourself to NMBE style questions. 

For international medical students and graduates, the Kaplan videos plus books are an excellent option. Many international medical schools focus on subjects and topics not considered high yield in America, but don’t cover topics important for the USMLE step 1, at least not in the detail required in the U.S. 


This is a question bank that works well as an additional resource. Especially for those using First Aid early in medical school. We recommend getting the latest edition of First Aid in your first year along with a subscription to USMLE Rx. 

With each new subject you study, you can find the corresponding section in First Aid then find the corresponding questions and resources available on USMLE Rx. For example, when covering the cardiovascular system, you first read the section in First Aid. Then watch the USMLE Rx videos on the cardiovascular system. Review the flashcards for the system. The finally do the questions in the USMLE Rx question bank. If you still need more questions to help solidify the content, you can do questions from kaplan or Uworld. 

The Best Flash-card System

Flashcard systems that include spaced repetition are a must. Spaced repetition allows for you to more effectively and easily memorize all the facts you will find in First Aid and U World. There are a few popular spaced repetition based flash card systems and many more flash card systems and physical sets available.

Study Schedules

Making a study schedule is an important first step in your preparation. With all that you have to do and the limited time given for dedicated step 1 study at most schools, trying to get it all done without a plan will be difficult. We have for you here some sample study plans.